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    • 1. 发明授权
    • Wide area ablation of myocardial tissue
    • 广泛消融心肌组织
    • US08475440B2
    • 2013-07-02
    • US11953189
    • 2007-12-10
    • Marwan AbboudFredric L. MilderGeorge Klein
    • Marwan AbboudFredric L. MilderGeorge Klein
    • A61B18/02
    • A61B18/02A61B2017/22051A61B2018/0022A61B2018/0212A61B2018/0262
    • The present invention advantageously provides a method and system for cryogenically ablating large areas of tissue within the left atrium. In an exemplary embodiment a cryotherapy device includes a catheter body having a substantially fixed diameter, a proximal end and a distal end; a first lumen for permitting passage of a cooling fluid from the proximal end to the distal end; a second lumen permitting return of the cooling fluid from the distal end to the proximal end; and an ablation element expandable from a first diameter that is substantially the same as the diameter of the catheter body to a second diameter that is at least twice the diameter of the catheter body, the ablation element having a surface portion that conforms to the uneven surface topography of the cardiac tissue. The ablation element can include one or more balloon and/or a flexible element that is deformed by moving the distal end of the catheter toward the proximal end of the catheter. The surface of the balloon can further be shaped by regulation of pressure within the one or more balloons. In an exemplary method a tissue ablation device is provided and tissue in the antrum of the left atrium is ablated with the device. In an exemplary method, only tissue in the antrum is ablated, and the ablation is created by freezing tissue.
    • 本发明有利地提供了用于低温切除左心房内的大面积组织的方法和系统。 在示例性实施例中,冷冻治疗装置包括具有基本上固定的直径,近端和远端的导管主体; 用于允许冷却流体从近端通向远端的第一腔; 允许冷却流体从远端返回到近端的第二管腔; 以及可从第一直径扩张的消融元件,所述第一直径基本上与所述导管主体的直径相同至所述导管主体直径的至少两倍的第二直径,所述消融元件具有与所述不平坦表面一致的表面部分 心脏组织的形貌。 消融元件可以包括通过将导管的远端朝向导管的近端移动而变形的一个或多个气囊和/或柔性元件。 球囊的表面可以通过调节一个或多个气囊内的压力而进一步成形。 在一种示例性方法中,提供组织消融装置,并且使用装置消融左心房窦内的组织。 在示例性方法中,只有窦中的组织被消融,并且通过冷冻组织产生消融。
    • 6. 发明授权
    • Catheter with cryogenic and electrical heating ablation
    • 导管用低温和电加热消融
    • US07896870B2
    • 2011-03-01
    • US11768259
    • 2007-09-10
    • Steven G. ArlessFredric L. MilderMarwan AbboudDan WittenbergerSean Carroll
    • Steven G. ArlessFredric L. MilderMarwan AbboudDan WittenbergerSean Carroll
    • A61B18/02A61B18/12A61B18/18
    • A61B18/02A61B18/1492A61B18/18A61B2017/00243A61B2018/0212A61B2018/0268
    • A catheter includes a cryoablation tip with an ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber and have an RF electrode at its distal end. The electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled in combination with an RF treatment regimen to enhance the lesion size, speed or placement of multi-lesion or single lesion cycles. In one embodiment a microwave energy source operates to extend beyond the thermal conduction depth, or penetrate the ice ball and be absorbed in tissue beyond an ice boundary, thus extending a dimension of treatment. Also, the cooling and application of RF energy can be controlled to position the ablation region away from the surface contacted by the electrode thereby leaving surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth.
    • 导管包括具有用于加热组织的消融组件的冷冻消融尖端。 冷冻消融尖端可以用冷却室实现,并且在其远端具有RF电极。 可以操作电极以温热低温冷却的组织,或者可以与RF治疗方案结合控制冷却剂,以增强病变大小,速度或多损伤或单个病变周期的放置。 在一个实施例中,微波能量源的作用是延伸超过热传导深度,或者穿透冰球并被吸收在超过冰界的组织中,从而延伸处理的尺寸。 此外,可以控制RF能量的冷却和施加,以使消融区域远离与电极接触的表面,从而在深度消融时使表面组织不受伤害,或者提供具有更高均匀度的消融带,并且随着深度增加。
    • 8. 发明授权
    • Generic endoscopic instrument
    • 通用内窥镜仪器
    • US5275608A
    • 1994-01-04
    • US777090
    • 1991-10-16
    • Jeffrey L. FormanFredric L. MilderHenri F. deGuillebonIrving KalikowA. Ze'ev Hed
    • Jeffrey L. FormanFredric L. MilderHenri F. deGuillebonIrving KalikowA. Ze'ev Hed
    • A61B17/28A61B17/32
    • A61B17/29A61B17/2909A61B2017/291A61B2017/2927
    • A surgical tool for operating within a body cavity through a small diameter opening includes a substantially rigid member which is elongated along a first axis and which has a cross-sectional dimension to fit within the opening. A head is mounted on one end of the rigid member for movement in at least one plane through an angle with respect to the first axis. An operable control member is mounted on an opposite end of the rigid member for having at least one degree of manipulability. The control member is coupled to the head member through the rigid member such that manipulation of the control member through an angle with respect to the first axis causes movement of the head member through a corresponding angle. Accordingly, the head member can be steered within a body cavity by control external to the body cavity. In some embodiments, the control member is manipulable to a second degree for actuating an actuating member mounted on the head.
    • 用于通过小直径开口在体腔内操作的手术工具包括基本上刚性的构件,其沿着第一轴线是细长的,并且具有适合于开口内的横截面尺寸。 头部安装在刚性构件的一端上,用于在至少一个平面中相对于第一轴线移动一个角度。 可操作的控制构件安装在刚性构件的相对端上,用于具有至少一个操纵程度。 控制构件通过刚性构件联接到头部构件,使得控制构件相对于第一轴线的角度的操纵引起头部构件相应角度的移动。 因此,通过体腔外部的控制可以将头部构件转向体腔内。 在一些实施例中,控制构件可操纵到第二程度,用于致动安装在头部上的致动构件。
    • 10. 发明申请
    • WIDE AREA ABLATION OF MYOCARDIAL TISSUE
    • 心肌组织的大面积消融
    • US20080215043A1
    • 2008-09-04
    • US12120439
    • 2008-05-14
    • Marwan AbboudFredric L. MilderGeorge Klein
    • Marwan AbboudFredric L. MilderGeorge Klein
    • A61B18/02
    • A61B18/02A61B2017/22051A61B2018/0022A61B2018/0212A61B2018/0262
    • The present invention advantageously provides a method and system for cryogenically ablating large areas of tissue within the left atrium. In an exemplary embodiment a cryotherapy device includes a catheter body having a substantially fixed diameter, a proximal end and a distal end; a first lumen for permitting passage of a cooling fluid from the proximal end to the distal end; a second lumen permitting return of the cooling fluid from the distal end to the proximal end; and an ablation element expandable from a first diameter that is substantially the same as the diameter of the catheter body to a second diameter that is at least twice the diameter of the catheter body, the ablation element having a surface portion that conforms to the uneven surface topography of the cardiac tissue. The ablation element can include one or more balloon and/or a flexible element that is deformed by moving the distal end of the catheter toward the proximal end of the catheter. The surface of the balloon can further be shaped by regulation of pressure within the one or more balloons. In an exemplary method a tissue ablation device is provided and tissue in the antrum of the left atrium is ablated with the device. In an exemplary method, only tissue in the antrum is ablated, and the ablation is created by freezing tissue.
    • 本发明有利地提供了用于低温切除左心房内的大面积组织的方法和系统。 在示例性实施例中,冷冻治疗装置包括具有基本上固定的直径,近端和远端的导管主体; 用于允许冷却流体从近端通向远端的第一腔; 允许冷却流体从远端返回到近端的第二管腔; 以及可从第一直径扩张的消融元件,所述第一直径基本上与所述导管主体的直径相同至所述导管主体直径的至少两倍的第二直径,所述消融元件具有与所述不平坦表面一致的表面部分 心脏组织的形貌。 消融元件可以包括通过将导管的远端朝向导管的近端移动而变形的一个或多个气囊和/或柔性元件。 气球的表面可以通过调节一个或多个气囊内的压力而进一步成形。 在一种示例性方法中,提供组织消融装置,并且使用装置消融左心房窦内的组织。 在示例性方法中,只有窦中的组织被消融,并且通过冷冻组织产生消融。